Laparoscopic Left Hemicolectomy

Abstract

What is the clear definition of left colectomy? Unfortunately, the answer is not as clear as it is with a right colectomy. The resection can involve resection of the colonic segment anywhere between the left transverse colon and the upper rectum. For tumors involving the left transverse colon or splenic flexure, left hemicolectomy (LC) is the preferred operation. A LC is considered to be a resection of the mid-transverse colon to the descending/sigmoid junction. In complete mesocolic excision (CME) and central vascular ligation (CVL) for left transverse colon or splenic flexure colon cancer, ligation of the inferior mesenteric vein (IMV), left branch of the middle colic artery (lt-MCA), and left colic artery (LCA) at the root must be considered [1]. For resection of mid- or distal descending colon tumors, the oncological resection requires division of the inferior mesenteric artery at its origin. If the resection carried out involved the distal transverse colon up to the sigmoid-descending junction, it should be considered as a left segmentary colectomy [2].